|Publication number||US6599250 B2|
|Application number||US 09/809,915|
|Publication date||Jul 29, 2003|
|Filing date||Mar 16, 2001|
|Priority date||Mar 17, 2000|
|Also published as||CA2403256A1, EP1265525A2, EP1949850A2, EP1949850A3, EP1949851A2, EP1949851A3, US20010025137, WO2001070103A2, WO2001070103A3|
|Publication number||09809915, 809915, US 6599250 B2, US 6599250B2, US-B2-6599250, US6599250 B2, US6599250B2|
|Inventors||James D. Webb, Tom Dean Bennett|
|Original Assignee||Medtronic, Inc.|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (27), Referenced by (280), Classifications (15), Legal Events (4)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This application claims the benefit of provisional application Ser. No. 60/190,212 filed Mar. 17, 2000.
The present invention relates to implantable hemodynamic monitors (IHMs). Specifically, the invention relates to systems that interface with various hospital monitoring systems to transfer data from the IHMs to doctors and other data processing centers. More specifically, the invention pertains to heart failure data management systems that provide a concise and reliable summary view of information in a manner that is useful for clinicians and health care personnel to monitor, assess, evaluate and treat heart failure conditions in patients. Further, the invention pertains to a system of a bi-directional communication system that is network, Internet, intranet and worldwide web compatible to enable chronic monitoring based on data obtained from the IHMs.
The need to monitor, on a frequent and continuous basis, the vital signs associated with hospitalized patients particularly those who are seriously ill is an important aspect of health care. Virtually every hospitalized patient requires periodic measurement in logging of blood pressure, temperature, pulse rate, etc. Such monitoring has typically been performed by having a health care worker periodically visit the bedside of the patient and measuring and/or observing the patient's vital signs using dedicated equipment that is either hooked up to the patient or brought into the patient's room. Such a monitoring procedure is not ideally cost-effective because of its being highly labor intensive.
A great many implantable medical devices (IMDs) for cardiac monitoring and/or therapy whose sensors are located in a blood vessel or heart chamber and coupled to an implantable monitor or therapy delivery device are used for diagnosis and therapy. Such systems include, for example, implantable heart monitors, therapy delivery devices, and drug delivery devices. All these systems include electrodes for sensing and sense amplifiers for recording and/or deriving sense event signals from the intracardiac electrogram (EGM). In current cardiac IMDs that provide a therapy, sensed event signals are used to control the delivery of the therapy in accordance with an operating algorithm. Selected EGM signal segments and sensed event histogram data or the like are stored in an internal RAM for telemetry to be transmitted to an external programmer at a later time. Efforts have also been underway for many years to develop implantable physiologic signal transducers and sensors for temporary or chronic use in a body organ or vessel usable with such IHMs for monitoring a physiologic condition other than, or in addition to, the disease state that is to be controlled by a therapy delivered by the IMD.
A comprehensive listing of implantable therapy devices are disclosed in conjunction with implantable sensors for sensing a wide variety of cardiac physiologic signals in U.S. Pat. No. 5,330,505, incorporated herein in its entirety by this reference.
Typically, an IHM measures blood pressure and temperature signal values which stem from changes in cardiac output that may be caused by cardiac failure, ventricular tachycardia, flutter or fibrillation. These variations may reflect a change in the body's need for oxygenated blood. For example, monitoring of a substantial drop in blood pressure in a heart chamber, particularly the right ventricle, along or in conjunction with an accelerated or chaotic EGM, was proposed as an indicator of a fibrillation or tachycardia sufficient to trigger automatic delivery of defibrillation or cardioversion shock. More recently, it has been proposed to monitor the changes in blood pressure by comparing those values that accompany the normal heart contraction and relaxation to those that occur during high-rate tachycardia, flutter or fibrillation.
A number of cardiac pacing systems and algorithms for processing monitored mean blood pressure or monitored dp/dt have been proposed and in some instances employed clinically for treating bradycardia. Such systems and algorithms are designed to sense and respond to mean or dp/dt changes in blood pressure to change the cardiac pacing rate between an upper and a lower pacing rate limit in order to control cardiac output. Examples of IHMs blood pressure and temperature sensors that derive absolute blood pressure signals and temperature signals are disclosed in commonly assigned U.S. Pat. Nos. 5,368,040, 5,535,752 and 5,564,434, and in U.S. Pat. No. 4,791,931, all incorporated by reference herein.
The Medtronic® Chronicle™ Implantable Hemodynamic Monitor (IHM) disclosed in U.S. Pat. Nos. 6,024,704 and 6,152,885, both incorporated herein by reference in their totality, employ the leads and circuitry disclosed in the above-incorporated commonly assigned U.S. Pat. Nos. 5,535,752 and 5,564,434 patents to record absolute blood pressure values for certain intervals. The recorded data is transmitted to a programmer under the control of a physician in an uplink telemetry transmission from the IHM during a telemetry session initiated by downlink telemetry transmission from the programmer's radio frequency (RF) head and receipt of an integration command by the IHM. Thus, in accordance to the '704 and '885 patents, a method is disclosed in which an IHM is used for deriving reference and absolute pressure signal values using implantable physiologic sensors to detect relative cardiac pressure signal values for storage and transmission.
Further, in accordance with the '704 and '885 patents, calibration of the reference pressure and/or temperature sensors in relation to an external calibrated barometric pressure and/or body temperature sensors could be accomplished. In addition, the same system may be used to interlace digital signal values related to pulmonary artery diastolic pressures with the primary cardiac pressure signal values derived from the right ventricle as disclosed in U.S. Pat. No. 6,155,267, incorporated herein by reference.
Heart failure is a progressive disease. While treatment slows the progression of the disease, current technology does not provide a cure. The best treatment regimen available to date is a combination of continuous diagnosis and drug therapy. Once a heart failure patient is in the hospital, current technology does not provide a continuous means of monitoring the patient during their stay in the hospital. Current practice is based on a dedicated programmer that is used to gain access to the pressure waveforms. Only trained physicians can currently uplink the data, and this is available only when such a trained physician is present, and is therefore not available on a continuous basis.
The present invention enables continuous remote monitoring of patients. In sharp contrast, prior heart failure management involves taking measurements of a few variables in the clinic with accurate catheterization pressures taken only occasionally because of the difficulty of obtaining them.
Accordingly, there is a need to provide continuous and reliable measurements over sustained long period of time. Further, emerging trends in health care including remote patient management systems require that the IMD/IHM be compatible with communication systems, including the Internet, the worldwide web, and similar systems to provide real-time communications and data exchange between the IHM in a patient and a remote center where physicians and other experts reside.
The present invention relates to chronic data management for cardiac systems. Specifically, the invention pertains to IHMs that monitor heart failure. In its broader aspect, the invention relates to patient management that enables the collection of chronic data for remote patient management, including remote delivery of clinical diagnosis and therapy.
Yet another aspect of the invention includes a user-friendly screen-displayable data management system that presents clinically relevant measurements. Another aspect of the invention provides a software system that enables the translation and transposition of IHM collected data to be presented to a clinician in a manner to enable efficient and reliable evaluation of patient conditions remotely.
The invention further relates to data reduction in a monitoring system as generally disclosed in co-pending application entitled “Implantable Medical Devices Monitoring Method and System Regarding Same” filed on Dec. 15, 1999, U.S. application Ser. No. 09/992,978, incorporated herein by reference in its entirety.
The present invention, inter alia, enables the transfer of a patient's medical data to one or more monitoring stations staffed by expert personnel to have access to the data in real time. Although the IHM device implemented in the present invention relates to the measurement of cardiac pressure, other IHM devices that detect and transmit additional physiological signals such as oxygen saturation, pulmonary artery diastolic and systolic pressure, temperature and related data may be used as the originating device or data source. Transferring real-time signals from IHMs to various physician portals and locations provides a highly accentuated medical service and effective chronic monitoring of patients.
In one aspect of the present invention an IHM device determines the hemodynamic status of a patient from measurement of pulmonary pressure and right atrial pressure obtained from a single absolute pressure sensor implanted in the right ventricle. Both of these values have been shown to correlate to the degree and extent of cardiac failure of a patient. The IHM continually monitors the right ventricular pressure using an absolute pressure sensor and marks the right ventricular pressure at the moment of specific events.
One aspect of the present invention is to provide a means by which physicians could view data available via real-time telemetry other than using a local data retrieving system, such as a programmer. Currently, physicians use the programmer to view the real-time pressure wave along with the EGM tracing. Using the present invention, the IHM device would be able to telemeter real time signals to a system via a programmer or other instrument to a remote location.
Another aspect of the present invention relates to the presentation of data from IHMs in a summary view that's useful and familiar to clinicians and patients. Yet another aspect of the present invention includes a process by which data is collected by IHMs, which data includes but is not limited to heart rate patient activity and pressure data, to establish that the patient is in a state of repeatable data routine on a daily basis. For example, this might mean application of a magnet when the patient is lying down, or using devices such as time-of-day counters, activity sensors, posture sensors, etc. Such data is retrieved for analysis via home monitors, programmers or similar devices, and the data sent over an Internet/intranet, worldwide web or a similar network to a remote location for analysis by clinicians or for storage and archiving at a Medtronic server.
The data is processed for collection with past pull-up records to compose a continuous patient record. Specifically, clinically relevant measurements are pulled out of the data. This would mean observing the average values measured during a daily test, including, for example, the patient reclining for 5 minutes. These values and the deviation or change are compared against clinical norms and flagged for the user if they are abnormal. For example, color plus footnote designations may be used to identify or flag abnormal data. Other variations such as italics, specialized fonts, bigger fonts, e-mail reports, faxed reports may be used to identify deviations from normal clinical data or established chronological data for the patient. The clinical norms can optionally be modified for each patient by the clinician and then serve as a clinical baseline for the particular patient.
One other aspect of the present invention is the display of data which without limitation, includes the most recent daily test data along with data from the previously interrogated data. A comparative value between the two and a previous interrogation date to compare collected data with chronological data are used.
Yet another aspect of the present invention includes a single page view of chronic heart failure status, translation of raw data into clinical indicators of heart failure status, analysis of changes in indicators over a user-selectable time period, flags and indicators to identify changes that are outside of clinical norms, tailoring of graphical displays and data management to a patient's clinical norms, means to determine if the patient is in a state of repeatable condition from day to day, and automated data analysis triaging which provides a foundation for further data analysis and automation.
FIG. 1A shows a diagram illustrating an implantable medical device that incorporates an absolute cardiac blood pressure sensor and an IHM device in accordance with the present invention.
FIG. 1B is a block diagram illustrating various data communication systems from the IMD.
FIG. 1C is a block diagram illustrating signal transmission from the IMD to a remote station.
FIG. 2 is a block diagram illustrating the remote communication system within which the present invention is incorporated.
FIG. 3 is a block diagram representing a web browser and portal interface for the present invention.
FIG. 4A is a block diagram representation illustrating a Medtronic home page at the Medtronic server in which data may be archived in accordance with the present invention.
FIG. 4B is a logic flowchart representing high level quick look summary in accordance with the present invention.
FIG. 5A is a representative sample of a welcome screen.
FIG. 5B is a representative hemodynamic variables display screen.
FIGS. 6 & 7 is a quick look summary in accordance with the present invention.
FIG. 8 is a representative screen for a trends report.
FIG. 9 is a representative screen for a trends report similar to FIG. 8.
FIG. 1A represents a patient with implanted medical device incorporating an absolute cardiac blood pressure sensor such as the IHM discussed hereinabove. Specifically, IHM/IMD 100 is coupled to an absolute cardiac blood pressure sensor 120 in a patient's heart 10 for recording absolute blood pressure values. IMD 100 is depicted implanted subcutaneously in the patient's chest region and it is coupled at its connector module 180 to a lead 112 extending through blood vessels into the right ventricle of the patient's heart 10. The blood pressure sensor 120 is located on lead 112 just proximal to the lead's distal tip 130 for passively fixing it in position to accommodate continuous movement of the heart 10. In this structure lead 112 and blood pressure sensor 120 correspond to those disclosed in detail in the above-incorporated commonly assigned '434 and '752 patents for deriving absolute blood pressure. The IMD 100 that monitors the physiological condition or state is programmable and/or can be interrogated by an external instrument such as a programmer through the use of bi-directional or RF telemetry that exchanges data and commands via uplink and downlink RF telemetry transmissions through the patient's skin.
In the context of an implantable blood pressure monitor a series of absolute blood pressure signal values are sensed periodically or in response to a signal provided by hospital personnel for example, a telemetry downlink signal to initiate real time data transmission. The absolute blood pressure value signals are continuously transmitted so that physicians, clinicians, nurses or other medical experts can determine the status of the patient's cardiac pressures and associated episodes recorded within the required time of day. The physician uses an external programmer to generate and transmit an interrogation command via a downlink telemetry transmission to the IMD 100. IMD 100 recognizes the command and initiates a continuous uplink telemetry transmission of the absolute pressure data in response. The uplink telemetry continues until the IMD system fails to detect further commands.
FIG. 1B illustrates a general scheme by which patient data could be transmitted to a remote clinician's station. The communication scheme enables continuous monitoring of patients either in a hospital setting or in a home environment. Pressure signals are acquired from the IMD via telemetry head 22 or equivalent device and uplinked to instrument 24. Instrument 24 may represent a programmer or an in-home monitor adapted to communicate with IMD 20. Instrument 24 maintains wireless communication 27 to transfer data to clinician's station 28. Alternatively, instrument 24 may be adapted to transfer data via network 30 representing Internet, extranet, worldwide web or a similar network. The data is then transferred to clinician's station via modem, cable or equivalent data transfer system.
FIG. 2 represents a detailed aspect of network 30 that is accessible to patients and physicians within which search engine 40 enables access to various zones 42, including a dedicated public zone 44, confidential zone 46 and private zone 48. These zones represent various data management centers that are either interconnected or segregated based on privacy and security requirements. For example, public zone 44 is accessible to all patients, physicians and the public to provide general information about medical devices and related medical information and services. In sharp contract, confidential database 46 and private information 48 are accessible to patients and physicians based on strict security and encryption systems for access on a need-to-know basis.
Referring now to FIG. 3, web browser and portal interface 50 representing patient portal 52, physician portal 54 and Medtronic (MDT) portal 56 are shown. These portals share a common database with additional secure database 58 and encryption system 60 interconnected therewith.
FIG. 4A is a general representation of a Medtronic home page 70 in accordance with the present invention. The home page is segregated between public and private/secure pages. Specifically, a physician section, patient section and a general public information section are depicted. The physician's section is highly scalable and operates both on the public and private secure sections. Similarly, the patient section relates to information on various medical devices including related therapy and diagnosis. Further, similar to the physician's site, the patient site includes private/confidential segments.
FIG. 4B represents a general logic flow diagram for a quick look summary in accordance with the present invention. Specifically, the system is initiated under logic step 80 where long-term data is collected via IMD 100. The long-term data is refined to determine if the patient is in a repeatable state under logic step 82. Subsequently, the data is retrieved and processed under logic step 84. Thereafter, under decision step 86 the values of the processed data are reviewed to see if they are abnormal. If these values prove to be abnormal, they are flagged as abnormal values under logic step 88 and the results are displayed under logic step 90. In the alternate, if the values are found to be normal, they are displayed under logic step 90. One of the significant aspects of the present invention is the presentation of highly user-friendly quick look summary of data collected by IMD/IHM 100 to clinicians, patients and other health providers.
Referring now to FIG. 5A, a representative screen encountered by a doctor using the Internet site provided in accordance with the present invention is shown. Specifically, the screen includes various tabs, one of which is to welcome the user. The welcome screen identifies the doctor and updates him or her on how many home monitoring records have been reviewed and how many abnormal events have been detected. The doctor is also informed of the number of patients who may require review. The doctor is also given various information regarding his or her practice and is also informed on what is new in the art vis a vis specific devices and medical conditions. The screen is highly interactive and based on past site use behavior of the doctor, the software is able to understand and retain the doctor's interests and highlight unused features.
In the “What is New” section, for instance, the screen interactively provides the doctor with the latest information regarding clinical studies including the devices that are released in the user's countries. The “Links” section provides links to related medical sites. The list of links is maintained by Medtronic, so only approved sites will appear. The list of potential links is narrowed by the user's areas of interest. Clinicians can also provide recommended links to their patients. This will appear in the patient portal and are customized by the recommended links, the type of devices the patient has implanted, the local language to be used and a track record of previous links that have been used.
Further, patient records of device and recorded data will be available for viewing and entry. This data may have been collected by home monitors, programmers, extenders, registration database or imported from clinic databases. Users can arrange the view of records, listable to their liking by date, name, ID and status. Specifically, status indicators are used for home monitoring data yet to be viewed or with errors. The records may include in-office follow-up test results, interrogated diagnostic data settings and measurements, data imported from pacing databases such as EKG indication, medications including control of compliance, monitoring functions, key physiologic data such as indications for implant, links to other online components of a patient's chart such as lab results, notes entered, data integrated across patient sessions such as episode logs and trends, patient demographics and patient diary entries.
The system may also be customized based on whether the portal is used to store in-home or programmer records for the particular patient. All parts of the patient's records that are attributable to the patient are clearly patient private data. Encryption and adequate authentication must be used for access. Attribution of who enters and edits changes is also supported by the system software.
Appointment scheduling provides an automatic means for scheduling home-monitoring sessions so home monitoring could be conducted without additional burden on the clinic scheduling staff. Physicians may enter their prescribed follow-up intervals and then the system can schedule the follow-up days. Patients can customize their schedule without the help of the clinical staff. The scheduling may also integrate with the clinic's in-office scheduling enabling doctor appointments to be made online.
Accounts billing are automated. Automation of the filling out of billing statements is also provided. Medical device follow-up regiments can often automatically be determined from session data. The data is forwarded to the clinician's billing system or a third party billing clearing house. Medtronic device registration forms will be web-enabled. Direct entry on the web or import from un-tethered data entry applications will be supported. Entry on the web will enable access by customers rather than field representatives without the high distribution and support cost encountered today with PC applications.
Clinical study content will be available to clinical study investigators. This could include entry of clinical data forms, discussion groups, newsletter and results reports. The site is customized based on which studies the user is a part of and the local language used. Physicians can compare their practice by comparing their practice data to data aggregated from other practices and practice guidelines. Specific comparison and points can be offered with custom filters. Eventually data mining may be offered. This will include and expand on the current capabilities of the CV views extranet applications. This part of the site could be customized based on collected user's data that is also made available for comparisons. Further, information about the user's practice to derive comparison definitions, for example with other practitioners in the area of expertise may be provided.
The site also includes reports for tracking product performance and will maintain tags on the referring physician. The distribution of reports is greatly enhanced through web-enabled features. Specifically, the content is tailored to each practice. For example, product performance can be incorporated with web devices such as a palm device which may be on the person of the patient or the physician. Similarly, the accuracy of reports can be enhanced by joining data. For example, closer monitoring reports may contain more accurate battery projections derived from follow-up and continuous monitoring of actual device data.
The system enables remote viewing. Specifically, users can remotely view patient stations through instruments connected to the Internet 30. Sessions with programmers, extenders, acute monitors and home monitors will be viewed through web browsers or a PC. Users will have access to a switchboard of available instruments they have rights to connect to and access the contents thereof. The connection is supported in any order whether it is browser or instrument first. Preferably, the site is customized by identifying which instruments the user has access rights to. Rights are assigned to physicians and clinical personnel as needed.
In the same manner, the link for patient portal 52 is a secure website for patients already implanted with Medtronic devices and their families. It includes the web content that requires secure access not available in the Medtronic public website 56. Patient portal 52 provides personalization, automatically providing only the information pertinent to the patient's device and disease. This is combined with a consistent user interface for the diverse applications being provided for a highly distributed user-friendly web experience.
Welcome screen 155 of FIG. 5A highlights important information with more detailed features. The site is customized by patient's names, what devices the patient has implanted, marketing preferences of what news or new products are of interest, physician control of what the patient has access to, past portal use to understand interests and highlight unused features, and what local language the patient uses.
One of the significant aspects of this site includes a home monitoring section which closes the loop for home-monitored patients. These patients can view whether sessions were successful or trouble-shoot errors. They can gain reassurance by viewing high-level results. Clearly this will reduce the burden of phone calls on clinicians. The site is customized by results of home monitoring sessions. The type of implanted device and home monitor that are proper to a patient are generally decisions made by the patient's physician. For security reasons home-monitoring results may be considered patient private data and will require encryption and user authentication. The site also provides appointment scheduling in which an automated means for scheduling home-monitoring sessions is implemented without additional burden on clinic scheduling staff. Physicians can enter their prescribed follow-up intervals and the system is intelligent to schedule the follow-up days. Patients can customize their schedule without the help of the clinical staff. The scheduling may also integrate with a clinic's in-office scheduling enabling doctor appointments to be made online.
Patient portal 52 also includes a diary section where daily medical journal entries can be captured. Voice or text can be captured either on the diary screen or potentially on a home monitor. Regardless of where it is entered, the diary screens would provide options to review and edit the contents of a diary. By putting the diary online, it is instantly available to all medical caregivers. Further, the diary does not need transcription or transfers to become part of a medical chart because of automatic entry.
Yet another significant aspect of the screen display at patient portal 52 includes the management of patient ID cards. Requests for replacements and validation of patient's information is automated on patient portal 52. Patients can also print out replacement ID cards for use while the processing of a permanent card is in progress. Patient portal 52 also enables patients to control the rights to their records. Specifically, patients will have rights to grant control and access rights to their records as they may deem necessary.
Referring to FIG. 5B, a quick look summary of hemodynamic variables 125 is represented. The screen provides one-week trends for hemodynamic variables RV pressure waves. For example, triggered episodes could be selected under a tachy-, brady- or patient-triggered events. A tachy-triggered event, for example, would inform the user if the patient has tachy-triggered events. Similarly, a brady-triggered event informs the user if the patient has brady-triggered events. Further, patient-triggered events relate to information indicating patient-triggered events.
Referring to FIG. 6, quick look summary screen 140 represents various parameters useful to determine a tachy or brady trigger. A tachy-trigger notification informs the user if the patient has tachy-triggered events. If there are tachy-triggered events the device information network for example, IHM 100, will notify the designated person, for instance a nurse, doctor or health provider electronically that events have occurred by e-mail, pager or other means. Similarly, a brady-triggered notification would be dispatched in the event there are brady-triggered events. IHM 100 will notify the designated person about the event. Patient-triggered notification is also dispatched in the same manner.
Referring to FIG. 7, under display screen 150, the software system enables analysis of comparative values based on a comparison of recent values to values interrogated on a prior time period. Patient portal 52 and physician portal 54 provide various ways of presenting clinical information. Specifically, daily minimums of heart rate for quick look, RV systolic pressure, daily minimums of RV diastolic pressure, daily minimums of estimated pulmonary artery pressure, daily minimums of RV pulse pressure, daily minimums of RV dp/dt, highlighting out-of-range heart rate, highlighting out-of-range RV systolic pressure, highlighting out-of-range RV diastolic pressure, highlighting out-of-range ePAD pressure, highlighting out-of-range RV pulse pressure, highlighting out-of-range RV dp/dt, notification of heart rate out-of-range, notification of RV systolic pressure out-of-range, notification of RV diastolic pressure, notification of ePAD pressure, notification of RV pulse pressure, notification of RV dp/dt out-of-range, highlighting changes in heart rate. Specifically, the quick look will determine and report changes in heart rate which have occurred in a patient between the daily minimum values contained in the file selected for examination and the daily minimum values from a previous file. More specifically, values are compared to determine if the differences lie outside a user-defined threshold is defined in the quick look setup and can be tailored on a patient-by-patient basis. This feature allows the user to define differences either based on actual values or percentages. Highlighting changes in RV systolic pressure relates to pressures which have occurred in a patient between the daily minimum values contained in the file selected for examination and the daily minimum values from a previous file.
Highlighting changes in RV diastolic pressure enables the quick look to determine and report changes in RV diastolic pressure which have occurred in a patient between the daily minimum values contained in the file selected for examination and the daily minimum values from a previous file. Similarly, the quick look will determine and report changes in RV pulse pressure which have occurred in a patient between the daily minimum values contained in the file selected for examination and the daily minimum values from a previous file. Highlighting changes in RV dp/dt includes determination and reporting of changes in RV dp/dt which have occurred in the patient between the daily minimum values contained in the file selected for examination and the daily minimum values from a previous file. Notification of large heart rate change is implemented by enabling IHM 100 information network to notify a designated person electronically that changes in heart rate greater than set targets have occurred. A notification may be sent by e-mail, pager and an equivalent medium.
Similar notification of large RV systolic pressure changes, large RV diastolic pressure changes, large ePAD pressure changes, large RV pulse pressure change, and RV dp/dt changes may be made. The quick look allows the user to select from a list of previous files. A specific file may be selected for data against which the current file is compared to determine if hemodynamic values have changed. Accordingly, quick look compares the daily minimum values from the selected file set of previous files to show the user variation that may have occurred. Additionally, while the quick look page allows the user to examine a selected file, its comparison to threshold values and comparison to a previous file, it also provides the daily minimum plots to enable the user to see a time/trend plot of all daily minimum values for all variables. Further, a daily minimum list may be used to examine a selected file, its comparison to threshold values and its comparison to a previous file to see a listing of all daily minimum values for all variables.
Referring now to FIGS. 8 and 9, trends report 160 and 170 are represented. Specifically, heart rate, patient activity, systolic and diastolic pressures and similar cardiac/physiologic parameters collected over a period of several weeks. Trend reports for night heart rate, +dp/dt and −dp/dt including pre-ejection systolic time intervals may be displayed. Trend directions for 12 months to 1 hour may be selected for review.
The preceding specific embodiments are illustrative of the practice of the invention. It is to be understood, therefore, that other expedients known to those of skill in the art or disclosed herein may be employed without departing from the invention or the scope of the appended claim. It is therefore to be understood that the invention may be practiced otherwise than is specifically described, without departing from the scope of the present invention. As to every element, it may be replaced by any one of infinite equivalent alternatives, only some of which are disclosed in the specification.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US4791931||Aug 13, 1987||Dec 20, 1988||Pacesetter Infusion, Ltd.||Demand pacemaker using an artificial baroreceptor reflex|
|US5330505||May 8, 1992||Jul 19, 1994||Leonard Bloom||System for and method of treating a malfunctioning heart|
|US5368040||Aug 2, 1993||Nov 29, 1994||Medtronic, Inc.||Apparatus and method for determining a plurality of hemodynamic variables from a single, chroniclaly implanted absolute pressure sensor|
|US5416695||Mar 9, 1993||May 16, 1995||Metriplex, Inc.||Method and apparatus for alerting patients and medical personnel of emergency medical situations|
|US5535752||Feb 27, 1995||Jul 16, 1996||Medtronic, Inc.||Implantable capacitive absolute pressure and temperature monitor system|
|US5564434||Feb 27, 1995||Oct 15, 1996||Medtronic, Inc.||Implantable capacitive absolute pressure and temperature sensor|
|US5576952||Mar 9, 1993||Nov 19, 1996||Metriplex, Inc.||Medical alert distribution system with selective filtering of medical information|
|US5720770||Oct 6, 1995||Feb 24, 1998||Pacesetter, Inc.||Cardiac stimulation system with enhanced communication and control capability|
|US5752976||Jun 23, 1995||May 19, 1998||Medtronic, Inc.||World wide patient location and data telemetry system for implantable medical devices|
|US5908383 *||Sep 17, 1997||Jun 1, 1999||Brynjestad; Ulf||Knowledge-based expert interactive system for pain|
|US5951300||Mar 10, 1997||Sep 14, 1999||Health Hero Network||Online system and method for providing composite entertainment and health information|
|US5954640 *||Jun 27, 1996||Sep 21, 1999||Szabo; Andrew J.||Nutritional optimization method|
|US6024704||Apr 30, 1998||Feb 15, 2000||Medtronic, Inc||Implantable medical device for sensing absolute blood pressure and barometric pressure|
|US6108577||Apr 26, 1999||Aug 22, 2000||Cardiac Pacemakers, Inc.||Method and apparatus for detecting changes in electrocardiogram signals|
|US6119033 *||Jun 23, 1997||Sep 12, 2000||Biotrack, Inc.||Method of monitoring a location of an area of interest within a patient during a medical procedure|
|US6152885||Apr 30, 1998||Nov 28, 2000||Medtronic, Inc.||Barometric pressure sensor for use with implantable absolute pressure sensor|
|US6155267||Dec 31, 1998||Dec 5, 2000||Medtronic, Inc.||Implantable medical device monitoring method and system regarding same|
|US6171252 *||Apr 29, 1999||Jan 9, 2001||Medtronic, Inc.||Pressure sensor with increased sensitivity for use with an implantable medical device|
|US6497655 *||Dec 17, 1999||Dec 24, 2002||Medtronic, Inc.||Virtual remote monitor, alert, diagnostics and programming for implantable medical device systems|
|EP0710465A1||Jul 14, 1995||May 8, 1996||Hewlett-Packard Company||Dynamic control of a patient monitoring system|
|EP0779057A1||Dec 13, 1995||Jun 18, 1997||Cardiac Telecom Corporation||Method and system for monitoring the heart of a patient|
|EP0796589A1||Feb 20, 1997||Sep 24, 1997||Siemens Medical Systems, Inc.||Method and apparatus for automatic configuration of a network node|
|WO1999041682A2||Feb 12, 1999||Aug 19, 1999||Southern Research Institute||Patient data acquisition unit and data support system|
|WO1999059460A2||May 17, 1999||Nov 25, 1999||Biosys Ab (Publ)||A medical measuring system|
|WO2000030529A1||Nov 9, 1999||Jun 2, 2000||Medtronic, Inc.||World wide patient location and data telemetry system for implantable medical devices|
|WO2000040146A1||Jan 6, 2000||Jul 13, 2000||Ball Semiconductor, Inc.||Wireless ekg|
|WO2000044274A2||Jan 28, 2000||Aug 3, 2000||Pougatchev Vadim I||Personal physiological monitor|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US6745175 *||Aug 2, 2001||Jun 1, 2004||National Instruments Corporation||System and method for a shared memory architecture for high speed logging and trending|
|US7027872||Jul 16, 2003||Apr 11, 2006||Medtronic, Inc.||Variable encryption scheme for data transfer between medical devices and related data management systems|
|US7177699 *||Apr 15, 2004||Feb 13, 2007||Medtronic, Inc.||Lifestyle management system|
|US7188151 *||Mar 28, 2002||Mar 6, 2007||Televital, Inc.||System and method for real-time monitoring, assessment, analysis, retrieval, and storage of physiological data over a wide area network|
|US7310551||Jun 2, 2005||Dec 18, 2007||Pacesetter, Inc.||Diagnostic gauge for cardiac health analysis|
|US7383238||Feb 24, 2004||Jun 3, 2008||The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration||Inductive monitoring system constructed from nominal system data and its use in real-time system monitoring|
|US7448996 *||Apr 15, 2003||Nov 11, 2008||Carematix, Inc.||Method and apparatus for remotely monitoring the condition of a patient|
|US7526335||Mar 10, 2005||Apr 28, 2009||Medtronic, Inc.||Communications system for an implantable device and a drug dispenser|
|US7528094||Oct 25, 2004||May 5, 2009||Medtronic, Inc.||Method and apparatus for providing safe long-range telemetry with implantable medical devices|
|US7530956||Jun 15, 2007||May 12, 2009||Cardiac Pacemakers, Inc.||Daytime/nighttime respiration rate monitoring|
|US7542995 *||Apr 11, 2006||Jun 2, 2009||Sun Microsystems, Inc.||Method and apparatus for detecting a change-point in a time-series of computer telemetry signals|
|US7658196||Apr 25, 2007||Feb 9, 2010||Ethicon Endo-Surgery, Inc.||System and method for determining implanted device orientation|
|US7682313||Sep 6, 2006||Mar 23, 2010||Vital Sensors Holding Company, Inc.||Implantable pressure monitor|
|US7686768||Jun 15, 2006||Mar 30, 2010||Vital Sensors Holding Company, Inc.||Implantable pressure monitor|
|US7704215||Apr 2, 2009||Apr 27, 2010||Cardiac Pacemakers, Inc.||Daytime/nighttime respiration rate monitoring|
|US7715906||Jun 4, 2007||May 11, 2010||Medtronic, Inc.||Method and apparatus for detecting noise in an implantable medical device|
|US7775215||Mar 7, 2006||Aug 17, 2010||Ethicon Endo-Surgery, Inc.||System and method for determining implanted device positioning and obtaining pressure data|
|US7775966||Mar 7, 2006||Aug 17, 2010||Ethicon Endo-Surgery, Inc.||Non-invasive pressure measurement in a fluid adjustable restrictive device|
|US7791467||Oct 16, 2007||Sep 7, 2010||Cardiac Pacemakers, Inc.||Repeater providing data exchange with a medical device for remote patient care and method thereof|
|US7844342||Feb 7, 2008||Nov 30, 2010||Ethicon Endo-Surgery, Inc.||Powering implantable restriction systems using light|
|US7927270||Jan 29, 2007||Apr 19, 2011||Ethicon Endo-Surgery, Inc.||External mechanical pressure sensor for gastric band pressure measurements|
|US7931597||Mar 15, 2010||Apr 26, 2011||Vital Sensors Holding Company, Inc.||Anchored implantable pressure monitor|
|US7931598||Mar 23, 2010||Apr 26, 2011||Vital Sensors Holding Company, Inc.||Implantable pressure monitor|
|US7949404||Apr 24, 2007||May 24, 2011||Medtronic, Inc.||Communications network for distributed sensing and therapy in biomedical applications|
|US7978062||May 9, 2008||Jul 12, 2011||Cardiac Pacemakers, Inc.||Medical data transport over wireless life critical network|
|US7987099||Feb 27, 2004||Jul 26, 2011||Align Technology, Inc.||Dental data mining|
|US8000532||Mar 5, 2007||Aug 16, 2011||Medtronic, Inc.||Digital pen to capture data in ambulatory monitored patients|
|US8016744||Mar 7, 2006||Sep 13, 2011||Ethicon Endo-Surgery, Inc.||External pressure-based gastric band adjustment system and method|
|US8016745||Apr 6, 2006||Sep 13, 2011||Ethicon Endo-Surgery, Inc.||Monitoring of a food intake restriction device|
|US8029443||Sep 26, 2008||Oct 4, 2011||Abbott Diabetes Care Inc.||Glucose measuring device integrated into a holster for a personal area network device|
|US8033998||Dec 28, 2006||Oct 11, 2011||Medtronic, Inc.||Device and method for automatic threshold setting|
|US8034065||Feb 26, 2008||Oct 11, 2011||Ethicon Endo-Surgery, Inc.||Controlling pressure in adjustable restriction devices|
|US8034294||Oct 11, 2004||Oct 11, 2011||Ideal Life, Inc.||Medical monitoring/consumables tracking device|
|US8052610||Dec 28, 2006||Nov 8, 2011||Medtronic, Inc.||Event registration for automatic threshold setting|
|US8057492||Feb 12, 2008||Nov 15, 2011||Ethicon Endo-Surgery, Inc.||Automatically adjusting band system with MEMS pump|
|US8062227||Oct 30, 2008||Nov 22, 2011||Medtronic, Inc.||Heart failure decompensation determination|
|US8066629||Feb 12, 2007||Nov 29, 2011||Ethicon Endo-Surgery, Inc.||Apparatus for adjustment and sensing of gastric band pressure|
|US8099305||Oct 30, 2007||Jan 17, 2012||Align Technology, Inc.||Dental data mining|
|US8100870||Dec 14, 2007||Jan 24, 2012||Ethicon Endo-Surgery, Inc.||Adjustable height gastric restriction devices and methods|
|US8114345||Feb 8, 2008||Feb 14, 2012||Ethicon Endo-Surgery, Inc.||System and method of sterilizing an implantable medical device|
|US8130093||Sep 2, 2010||Mar 6, 2012||Cardiac Pacemakers, Inc.||Repeater providing data exchange with a medical device for remote patient care and method thereof|
|US8142452||Dec 27, 2007||Mar 27, 2012||Ethicon Endo-Surgery, Inc.||Controlling pressure in adjustable restriction devices|
|US8152710||Feb 28, 2008||Apr 10, 2012||Ethicon Endo-Surgery, Inc.||Physiological parameter analysis for an implantable restriction device and a data logger|
|US8170636||Jun 5, 2007||May 1, 2012||Medtronic, Inc.||Optical sensor confidence algorithm|
|US8187162||Mar 6, 2008||May 29, 2012||Ethicon Endo-Surgery, Inc.||Reorientation port|
|US8187163||Dec 10, 2007||May 29, 2012||Ethicon Endo-Surgery, Inc.||Methods for implanting a gastric restriction device|
|US8192350||Jan 28, 2008||Jun 5, 2012||Ethicon Endo-Surgery, Inc.||Methods and devices for measuring impedance in a gastric restriction system|
|US8221439||Feb 7, 2008||Jul 17, 2012||Ethicon Endo-Surgery, Inc.||Powering implantable restriction systems using kinetic motion|
|US8229559||Jul 15, 2010||Jul 24, 2012||Medtronic, Inc.||Evaluation of implantable medical device data|
|US8229568||Mar 24, 2009||Jul 24, 2012||Medtronic, Inc.||Method and apparatus for providing safe long-range telemetry with implantable medical devices|
|US8233995||Mar 6, 2008||Jul 31, 2012||Ethicon Endo-Surgery, Inc.||System and method of aligning an implantable antenna|
|US8239028||Apr 24, 2009||Aug 7, 2012||Cyberonics, Inc.||Use of cardiac parameters in methods and systems for treating a chronic medical condition|
|US8251904||Jun 7, 2006||Aug 28, 2012||Roche Diagnostics Operations, Inc.||Device and method for insulin dosing|
|US8295938||Dec 4, 2007||Oct 23, 2012||Medtronic, Inc.||Programming a medical device with a general purpose instrument|
|US8319631||Jan 27, 2010||Nov 27, 2012||Cardiac Pacemakers, Inc.||Modular patient portable communicator for use in life critical network|
|US8337389||Jan 28, 2008||Dec 25, 2012||Ethicon Endo-Surgery, Inc.||Methods and devices for diagnosing performance of a gastric restriction system|
|US8337404||Oct 1, 2010||Dec 25, 2012||Flint Hills Scientific, Llc||Detecting, quantifying, and/or classifying seizures using multimodal data|
|US8346332||Jun 10, 2010||Jan 1, 2013||Medtronic, Inc.||Absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction|
|US8352008||Jun 10, 2010||Jan 8, 2013||Medtronic, Inc.||Active noise cancellation in an optical sensor signal|
|US8352039||Jan 6, 2011||Jan 8, 2013||Medtronic, Inc.||Programming therapy delivered by implantable medical device|
|US8373556||Jul 12, 2011||Feb 12, 2013||Cardiac Pacemakers, Inc.||Medical data transport over wireless life critical network|
|US8376953||Apr 25, 2011||Feb 19, 2013||Vital Sensors Holding Company, Inc.||Implantable pressure monitor|
|US8377079||Dec 27, 2007||Feb 19, 2013||Ethicon Endo-Surgery, Inc.||Constant force mechanisms for regulating restriction devices|
|US8382667||Apr 29, 2011||Feb 26, 2013||Flint Hills Scientific, Llc||Detecting, quantifying, and/or classifying seizures using multimodal data|
|US8382677||Apr 25, 2011||Feb 26, 2013||Vital Sensors Holding Company, Inc.||Anchored implantable pressure monitor|
|US8391975 *||Sep 28, 2005||Mar 5, 2013||Medtronic, Inc.||Telemetry of combined endocavitary atrial and ventricular signals|
|US8391979||Jun 10, 2010||Mar 5, 2013||Medtronic, Inc.||Shock reduction using absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction|
|US8395498||May 9, 2008||Mar 12, 2013||Cardiac Pacemakers, Inc.||Wireless patient communicator employing security information management|
|US8417344||Oct 24, 2008||Apr 9, 2013||Cyberonics, Inc.||Dynamic cranial nerve stimulation based on brain state determination from cardiac data|
|US8437840||Sep 26, 2011||May 7, 2013||Medtronic, Inc.||Episode classifier algorithm|
|US8438039||Apr 27, 2005||May 7, 2013||Medtronic, Inc.||User customizable workflow preferences for remote patient management|
|US8451113||Feb 10, 2012||May 28, 2013||Cardiac Pacemakers, Inc.||Repeater providing data exchange with a medical device for remote patient care and method thereof|
|US8452387||Sep 20, 2010||May 28, 2013||Flint Hills Scientific, Llc||Detecting or validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex|
|US8460243||Jun 10, 2003||Jun 11, 2013||Abbott Diabetes Care Inc.||Glucose measuring module and insulin pump combination|
|US8463345||Jun 10, 2010||Jun 11, 2013||Medtronic, Inc.||Device and method for monitoring of absolute oxygen saturation and total hemoglobin concentration|
|US8463346||Jun 10, 2010||Jun 11, 2013||Medtronic, Inc.||Absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction|
|US8489164||Oct 27, 2010||Jul 16, 2013||Medtronic, Inc.||Monitoring of tissue hemoglobin concentration|
|US8489168||Nov 18, 2010||Jul 16, 2013||Medtronic, Inc.||Coefficent determination for blood oxygen saturation and total hemoglobin concentration indices|
|US8494631||Aug 31, 2011||Jul 23, 2013||Medtronic, Inc.||System and method for profiling a patients hemodynamic response based on heart sounds|
|US8515537||Jun 10, 2010||Aug 20, 2013||Medtronic, Inc.||Tissue oxygenation monitoring in heart failure|
|US8515547||May 9, 2008||Aug 20, 2013||Cardiac Pacemakers, Inc.||Wireless patient communicator for use in a life critical network|
|US8521245||Oct 30, 2009||Aug 27, 2013||Medtronic, Inc.||Method and apparatus for post-shock evaluation using tissue oxygenation measurements|
|US8521269||Jun 27, 2012||Aug 27, 2013||Medtronic, Inc.||Determining tachyarrhythmia detection parameters based on prior detected episodes|
|US8521281||Oct 14, 2011||Aug 27, 2013||Medtronic, Inc.||Electrogram classification algorithm|
|US8540642||Jan 31, 2007||Sep 24, 2013||Medtronic, Inc.||Implantable medical device and method for physiological event monitoring|
|US8562536||Apr 29, 2010||Oct 22, 2013||Flint Hills Scientific, Llc||Algorithm for detecting a seizure from cardiac data|
|US8571620||Jun 10, 2010||Oct 29, 2013||Medtronic, Inc.||Tissue oxygenation monitoring in heart failure|
|US8571643||Sep 16, 2010||Oct 29, 2013||Flint Hills Scientific, Llc||Detecting or validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex|
|US8571880||Aug 6, 2004||Oct 29, 2013||Ideal Life, Inc.||Personal health management device, method and system|
|US8583221||Apr 26, 2012||Nov 12, 2013||Medtronic, Inc.||Method and apparatus for display of cardiac signal episodes with over- or under-sensing|
|US8585604||Oct 29, 2010||Nov 19, 2013||Medtronic, Inc.||Integrated patient care|
|US8587427||Feb 4, 2013||Nov 19, 2013||Cardiac Pacemakers, Inc.||Medical data transport over wireless life critical network|
|US8591395||Jan 28, 2008||Nov 26, 2013||Ethicon Endo-Surgery, Inc.||Gastric restriction device data handling devices and methods|
|US8591532||Feb 12, 2008||Nov 26, 2013||Ethicon Endo-Sugery, Inc.||Automatically adjusting band system|
|US8630708||Jul 29, 2010||Jan 14, 2014||Medtronic, Inc.||Method and apparatus for post-shock evaluation using tissue oxygenation measurements|
|US8634890||Jun 10, 2010||Jan 21, 2014||Medtronic, Inc.||Device and method for monitoring of absolute oxygen saturation and tissue hemoglobin concentration|
|US8634926||Sep 8, 2004||Jan 21, 2014||Medtronic, Inc.||Clinic based instrument system for remote processing and access to implanted systems information|
|US8638221||Nov 26, 2012||Jan 28, 2014||Cardiac Pacemakers, Inc.||Modular patient communicator for use in life critical network|
|US8639332||Jul 29, 2010||Jan 28, 2014||Medtronic, Inc.||Method and apparatus for post-shock evaluation using tissue oxygenation measurements|
|US8639333||Nov 21, 2011||Jan 28, 2014||Medtronic, Inc.||Method and apparatus for adaptive cardiac resynchronization therapy employing a multipolar left ventricular lead|
|US8641646||Jul 30, 2010||Feb 4, 2014||Cyberonics, Inc.||Seizure detection using coordinate data|
|US8649871||Apr 30, 2010||Feb 11, 2014||Cyberonics, Inc.||Validity test adaptive constraint modification for cardiac data used for detection of state changes|
|US8666466||Jun 10, 2010||Mar 4, 2014||Medtronic, Inc.||Device and method for monitoring of absolute oxygen saturation and tissue hemoglobin concentration|
|US8679009||Jun 15, 2010||Mar 25, 2014||Flint Hills Scientific, Llc||Systems approach to comorbidity assessment|
|US8684921||May 15, 2012||Apr 1, 2014||Flint Hills Scientific Llc||Detecting, assessing and managing epilepsy using a multi-variate, metric-based classification analysis|
|US8725239||Apr 25, 2011||May 13, 2014||Cyberonics, Inc.||Identifying seizures using heart rate decrease|
|US8744560||Sep 30, 2011||Jun 3, 2014||Medtronic, Inc.||Electrogram summary|
|US8761717||Aug 7, 2012||Jun 24, 2014||Brian K. Buchheit||Safety feature to disable an electronic device when a wireless implantable medical device (IMD) is proximate|
|US8768471||Mar 3, 2013||Jul 1, 2014||Cyberonics, Inc.||Dynamic cranial nerve stimulation based on brain state determination from cardiac data|
|US8774909||Sep 26, 2011||Jul 8, 2014||Medtronic, Inc.||Episode classifier algorithm|
|US8777850||Oct 31, 2008||Jul 15, 2014||Medtronic, Inc.||Heart failure patient management using an implantable monitoring system|
|US8781547||Oct 28, 2011||Jul 15, 2014||Medtronic, Inc.||Method and apparatus for calibrating an absolute oxygen saturation sensor|
|US8791815||Apr 25, 2013||Jul 29, 2014||Cardiac Pacemakers, Inc.||System and method providing data exchange with a medical device for remote patient care|
|US8812841||Jan 27, 2010||Aug 19, 2014||Cardiac Pacemakers, Inc.||Communications hub for use in life critical network|
|US8818522||Jul 31, 2013||Aug 26, 2014||Cardiac Pacemakers, Inc.||Wireless patient communicator for use in a life critical network|
|US8827904||Aug 31, 2005||Sep 9, 2014||Medtronic, Inc.||Automatic parameter status on an implantable medical device system|
|US8827912||Apr 27, 2010||Sep 9, 2014||Cyberonics, Inc.||Methods and systems for detecting epileptic events using NNXX, optionally with nonlinear analysis parameters|
|US8831732||Apr 30, 2010||Sep 9, 2014||Cyberonics, Inc.||Method, apparatus and system for validating and quantifying cardiac beat data quality|
|US8849409||Mar 3, 2013||Sep 30, 2014||Cyberonics, Inc.||Dynamic cranial nerve stimulation based on brain state determination from cardiac data|
|US8852100||Feb 25, 2013||Oct 7, 2014||Flint Hills Scientific, Llc||Detecting, quantifying, and/or classifying seizures using multimodal data|
|US8868182||Jul 16, 2012||Oct 21, 2014||Medtronic, Inc.||Device based cardiac monitoring and stress test|
|US8868185||Nov 27, 2012||Oct 21, 2014||Medtronic, Inc.||Use of thoracic and extra-thoracic impedance for diagnostic monitoring|
|US8870742||Feb 28, 2008||Oct 28, 2014||Ethicon Endo-Surgery, Inc.||GUI for an implantable restriction device and a data logger|
|US8882666||Apr 18, 2005||Nov 11, 2014||Ideal Life Inc.||Personal health monitoring and/or communication system|
|US8886296||Oct 14, 2011||Nov 11, 2014||Medtronic, Inc.||T-wave oversensing|
|US8888702||Dec 3, 2012||Nov 18, 2014||Flint Hills Scientific, Llc||Detecting, quantifying, and/or classifying seizures using multimodal data|
|US8918171||Jul 29, 2010||Dec 23, 2014||Medtronic, Inc.||Method and apparatus for post-shock evaluation using tissue oxygenation measurements|
|US8926523||Mar 12, 2013||Jan 6, 2015||Medtronic, Inc.||Method and apparatus for cardiac function monitoring|
|US8945006||Feb 24, 2014||Feb 3, 2015||Flunt Hills Scientific, LLC||Detecting, assessing and managing epilepsy using a multi-variate, metric-based classification analysis|
|US8948855||May 21, 2013||Feb 3, 2015||Flint Hills Scientific, Llc||Detecting and validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex|
|US8954030||May 15, 2014||Feb 10, 2015||Brian K. Buchheit||Safety feature to disable an electronic device when a wireless implantable medical device (IMD) is proximate|
|US8970392||Nov 5, 2013||Mar 3, 2015||Cardiac Pacemakers, Inc.||Medical data transport over wireless life critical network|
|US9020582||Sep 30, 2013||Apr 28, 2015||Flint Hills Scientific, Llc||Detecting or validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex|
|US9021358||Mar 14, 2014||Apr 28, 2015||eagleyemed, Inc.||Multi-site video based computer aided diagnostic and analytical platform|
|US9037238||Nov 21, 2011||May 19, 2015||Michael C. Soldner||Method for efficient delivery of dual site pacing|
|US9050469||Nov 24, 2004||Jun 9, 2015||Flint Hills Scientific, Llc||Method and system for logging quantitative seizure information and assessing efficacy of therapy using cardiac signals|
|US9092556||Oct 2, 2014||Jul 28, 2015||eagleyemed, Inc.||Multi-site data sharing platform|
|US9095718||Apr 3, 2013||Aug 4, 2015||Medtronic, Inc.||Heart-sounds based adaptive cardiac resynchronization therapy timing parameter optimization system|
|US9126049||Jun 10, 2010||Sep 8, 2015||Medtronic, Inc.||Shock reduction using absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction|
|US9180300||Aug 30, 2012||Nov 10, 2015||Medtronic, Inc.||Left-ventricular pacing site selection guided by electrogram morphology analysis|
|US9199087||Nov 21, 2011||Dec 1, 2015||Medtronic, Inc.||Apparatus and method for selecting a preferred pacing vector in a cardiac resynchronization device|
|US9220910||Jan 7, 2014||Dec 29, 2015||Cyberonics, Inc.||Seizure detection using coordinate data|
|US9241647||Oct 21, 2013||Jan 26, 2016||Cyberonics, Inc.||Algorithm for detecting a seizure from cardiac data|
|US9256910||Sep 21, 2011||Feb 9, 2016||Ideal Life, Inc.||Medical monitoring/consumables tracking device|
|US9265951||Jul 16, 2010||Feb 23, 2016||The Brigham And Women's Hospital||System and method for automated adjustment of cardiac resynchronization therapy control parameters|
|US9265954||Jul 26, 2013||Feb 23, 2016||Medtronic, Inc.||Method and system for improved estimation of time of left ventricular pacing with respect to intrinsic right ventricular activation in cardiac resynchronization therapy|
|US9265955||Jul 26, 2013||Feb 23, 2016||Medtronic, Inc.||Method and system for improved estimation of time of left ventricular pacing with respect to intrinsic right ventricular activation in cardiac resynchronization therapy|
|US9269251||Dec 19, 2014||Feb 23, 2016||Cardiac Pacemakers, Inc.||Medical data transport over wireless life critical network|
|US9272148||Jul 23, 2013||Mar 1, 2016||Medtronic, Inc.||Combination of feedback on mechanical and electrical resynchronization to select therapy parameters|
|US9278219||Mar 15, 2013||Mar 8, 2016||Medtronic, Inc.||Closed loop optimization of control parameters during cardiac pacing|
|US9278220||Jul 23, 2013||Mar 8, 2016||Medtronic, Inc.||Identification of healthy versus unhealthy substrate for pacing from a multipolar lead|
|US9282907||Jul 23, 2013||Mar 15, 2016||Medtronic, Inc.||Identification of healthy versus unhealthy substrate for pacing from a multipolar lead|
|US9313192||Jul 28, 2014||Apr 12, 2016||Cardiac Pacemakers, Inc.||Communications hub for use in life critical network|
|US9320446||Mar 27, 2014||Apr 26, 2016||Medtronic, Inc.||Bioelectric sensor device and methods|
|US9402550||Apr 29, 2011||Aug 2, 2016||Cybertronics, Inc.||Dynamic heart rate threshold for neurological event detection|
|US9468385||Aug 22, 2014||Oct 18, 2016||Medtronic, Inc.||Visual representation of a cardiac signal sensing test|
|US9468766||Aug 7, 2015||Oct 18, 2016||Medtronic, Inc.||Sensing and atrial-synchronized ventricular pacing in an intracardiac pacemaker|
|US9468772||Jan 21, 2015||Oct 18, 2016||Medtronic, Inc.||Multi-device implantable medical device system and programming methods|
|US9474457||Feb 26, 2014||Oct 25, 2016||Medtronic, Inc.||Metrics of electrical dyssynchrony and electrical activation patterns from surface ECG electrodes|
|US9486151||Feb 26, 2014||Nov 8, 2016||Medtronic, Inc.||Metrics of electrical dyssynchrony and electrical activation patterns from surface ECG electrodes|
|US9492245||Mar 23, 2007||Nov 15, 2016||Align Technology, Inc.||Method and system for providing dynamic orthodontic assessment and treatment profiles|
|US9498162||Apr 25, 2011||Nov 22, 2016||Cyberonics, Inc.||Identifying seizures using heart data from two or more windows|
|US9504390||Sep 13, 2013||Nov 29, 2016||Globalfoundries Inc.||Detecting, assessing and managing a risk of death in epilepsy|
|US9510763||May 2, 2012||Dec 6, 2016||Medtronic, Inc.||Assessing intra-cardiac activation patterns and electrical dyssynchrony|
|US9552722||Dec 23, 2013||Jan 24, 2017||Cardiac Pacemakers, Inc.||Modular communicator for use in life critical network|
|US9586050||May 4, 2015||Mar 7, 2017||Medtronic, Inc.||Systems and methods for configuration of atrioventricular interval|
|US9586052||May 4, 2015||Mar 7, 2017||Medtronic, Inc.||Systems and methods for evaluating cardiac therapy|
|US9591982||Apr 24, 2015||Mar 14, 2017||Medtronic, Inc.||Systems and methods for evaluating cardiac therapy|
|US9592392||Aug 7, 2015||Mar 14, 2017||Medtronic, Inc.||Sensing and atrial-synchronized ventricular pacing in an intracardiac pacemaker|
|US9597511||Oct 30, 2012||Mar 21, 2017||Medtronic, Inc.||Method to assess hemodynamic performance during cardiac resynchronization therapy optimization using admittance waveforms and derivatives|
|US9597513||Aug 7, 2015||Mar 21, 2017||Medtronic, Inc.||Sensing and atrial-synchronized ventricular pacing in an intracardiac pacemaker|
|US9643014||Nov 15, 2011||May 9, 2017||Medtronic, Inc.||System and method for pacing parameter optimization using heart sounds|
|US9649497||Mar 7, 2016||May 16, 2017||Medtronic, Inc.||Closed loop optimization of control parameters during cardiac pacing|
|US9656087||Oct 22, 2015||May 23, 2017||Medtronic, Inc.||Delivery of bi-ventricular pacing therapy in a cardiac medical device and medical device system|
|US9668668||Sep 30, 2011||Jun 6, 2017||Medtronic, Inc.||Electrogram summary|
|US9675315||Mar 12, 2013||Jun 13, 2017||Medtronic, Inc.||Method and apparatus for cardiac function monitoring|
|US9700256||Dec 7, 2015||Jul 11, 2017||Cyberonics, Inc.||Algorithm for detecting a seizure from cardiac data|
|US9700728||Feb 29, 2016||Jul 11, 2017||Medtronic, Inc.||Combination of feedback on mechanical and electrical resynchronization to select therapy parameters|
|US9743859||Feb 19, 2010||Aug 29, 2017||Cardiac Pacemakers, Inc.||Daytime/nighttime respiration rate monitoring|
|US9744365||Jan 7, 2011||Aug 29, 2017||Medtronic, Inc.||Presentation of information associated with medical device therapy|
|US9750941||Jan 22, 2016||Sep 5, 2017||Medtronic, Inc.||Criteria for determination of local tissue latency near pacing lead electrodes|
|US9764143||May 4, 2015||Sep 19, 2017||Medtronic, Inc.||Systems and methods for configuration of interventricular interval|
|US9776009||Mar 20, 2014||Oct 3, 2017||Medtronic, Inc.||Non-invasive detection of phrenic nerve stimulation|
|US20020198473 *||Mar 28, 2002||Dec 26, 2002||Televital, Inc.||System and method for real-time monitoring, assessment, analysis, retrieval, and storage of physiological data over a wide area network|
|US20030028552 *||Aug 2, 2001||Feb 6, 2003||Pierce David Mark||System and method for a shared memory architecture for high speed logging and trending|
|US20040059603 *||Apr 15, 2003||Mar 25, 2004||Brown Jacob Theodore||System and method for virtual health services|
|US20040102683 *||Apr 15, 2003||May 27, 2004||Khanuja Sukhwant Singh||Method and apparatus for remotely monitoring the condition of a patient|
|US20040199221 *||Apr 15, 2004||Oct 7, 2004||Medtronic, Inc.||Lifestyle management system|
|US20040215247 *||Jan 12, 2004||Oct 28, 2004||Armin Bolz||Method and device for detecting an anomaly in the cardiac activity of a patient|
|US20050020887 *||Jun 15, 2004||Jan 27, 2005||Jason Goldberg||Medical monitoring device and system|
|US20050066335 *||Sep 23, 2003||Mar 24, 2005||Robert Aarts||System and method for exposing local clipboard functionality towards external applications|
|US20050071197 *||Aug 6, 2004||Mar 31, 2005||Jason Goldberg||Personal health management device, method and system|
|US20050192835 *||Feb 27, 2004||Sep 1, 2005||Align Technology, Inc.||Dental data mining|
|US20050241026 *||Apr 22, 2004||Oct 27, 2005||Cardiac Pacemakers, Inc.||Providing and communicating data message alerts stored on medical devices|
|US20050261934 *||Jul 16, 2003||Nov 24, 2005||Medtronic, Inc.||Variable encryption scheme for data transfer between medical devices and related data management systems|
|US20060052842 *||Sep 8, 2004||Mar 9, 2006||Hess Michael F||Clinic based instrument system for remote processing and access to implanted systems information|
|US20060064020 *||Sep 20, 2004||Mar 23, 2006||Medtronic, Inc.||Clinic dashboard monitor|
|US20060064136 *||Sep 23, 2004||Mar 23, 2006||Medtronic, Inc.||Method and apparatus for facilitating patient alert in implantable medical devices|
|US20060089684 *||Oct 25, 2004||Apr 27, 2006||Blaha Eric V||Method and apparatus for providing safe long-range telemetry with implantable medical devices|
|US20060206066 *||Mar 10, 2005||Sep 14, 2006||Bozidar Ferek-Petric||Communications system for an implantable device and a drug dispenser|
|US20060206067 *||Mar 10, 2005||Sep 14, 2006||Bozidar Ferek-Petric||Communications system for an implantable device and a drug dispenser|
|US20070060797 *||Aug 31, 2005||Mar 15, 2007||Ball James J||Automatic parameter status on an implantable medical device system|
|US20070073346 *||Sep 28, 2005||Mar 29, 2007||Giorgio Corbucci||Telemetry of combined endocavitary atrial and ventricular signals|
|US20070073347 *||Sep 28, 2005||Mar 29, 2007||Giorgio Corbucci||Telemetry of combined endocavitary atrial and ventricular signals|
|US20070118038 *||Jun 15, 2006||May 24, 2007||Vital Sensors Inc.||Implantable device for telemetric measurement of blood pressure/temperature within the heart|
|US20070238065 *||Mar 23, 2007||Oct 11, 2007||Align Technology, Inc.||Method and System for Providing Dynamic Orthodontic Assessment and Treatment Profiles|
|US20070239740 *||Apr 11, 2006||Oct 11, 2007||Sajjit Thampy||Method and apparatus for detecting a change-point in a time-series of computer telemetry signals|
|US20070299480 *||Apr 24, 2007||Dec 27, 2007||Hill Gerard J||Communications network for distributed sensing and therapy in biomedical applications|
|US20080065416 *||Oct 16, 2007||Mar 13, 2008||Mazar Scott T||Repeater Providing Data Exchange With A Medical Device For Remote Patient Care And Method Thereof|
|US20080071328 *||Sep 5, 2007||Mar 20, 2008||Medtronic, Inc.||Initiating medical system communications|
|US20080085487 *||Oct 30, 2007||Apr 10, 2008||Align Technology, Inc.||Dental Data Mining|
|US20080140157 *||Dec 4, 2007||Jun 12, 2008||Medtronic, Inc.||Programming a medical device with a general purpose instrument|
|US20080140160 *||May 4, 2007||Jun 12, 2008||Medtronic, Inc.||Intelligent discovery of medical devices by a programming system|
|US20080161657 *||Dec 28, 2006||Jul 3, 2008||Bullens Roland W M||Device and Method for Automatic Threshold Setting|
|US20080161701 *||Dec 28, 2006||Jul 3, 2008||Bullens Roland W M||Event Registration for Automatic Threshold Setting|
|US20080183085 *||Jan 31, 2007||Jul 31, 2008||Van Oort Geeske||Implantable medical device and method for physiological event monitoring|
|US20080208007 *||Mar 5, 2007||Aug 28, 2008||Van Hove Jos W||Digital Pen to Capture Data in Ambulatory Monitored Patients|
|US20080270036 *||Apr 27, 2007||Oct 30, 2008||Webb James D||Systems and methods facilitating auxiliary analysis of data from implanted medical devices|
|US20080288293 *||Jun 24, 2008||Nov 20, 2008||Brown Jr Jacob T||System and method for virtual health services|
|US20080300497 *||Jun 4, 2007||Dec 4, 2008||Krause Paul G||Method and apparatus for detecting noise in an implantable medical device|
|US20080306390 *||Jun 5, 2007||Dec 11, 2008||Can Cinbis||Optical sensor confidence algorithm|
|US20080312541 *||Jun 15, 2007||Dec 18, 2008||Cardiac Pacemakers, Inc||Daytime/nighttime respiration rate monitoring|
|US20090058635 *||May 9, 2008||Mar 5, 2009||Lalonde John||Medical data transport over wireless life critical network|
|US20090319298 *||Jun 19, 2008||Dec 24, 2009||Weiss Sanford B||Patient status and healthcare information communication system and method|
|US20100113888 *||Oct 30, 2008||May 6, 2010||Medtronic,Inc.||Heart failure decompensation determination|
|US20100113890 *||Oct 31, 2008||May 6, 2010||Cho Yong K||Heart failure patient management using an implantable monitoring system|
|US20100169220 *||Dec 31, 2008||Jul 1, 2010||Microsoft Corporation||Wearing health on your sleeve|
|US20100174201 *||Mar 15, 2010||Jul 8, 2010||Vital Sensors Holding Company, Inc.||Anchored implantable pressure monitor|
|US20100185103 *||Mar 23, 2010||Jul 22, 2010||Vital Sensors Holding Company, Inc.||Implantable pressure monitor|
|US20100191076 *||Feb 19, 2010||Jul 29, 2010||Aaron Lewicke||Daytime/nighttime respiration rate monitoring|
|US20100317937 *||Jun 10, 2010||Dec 16, 2010||Kuhn Jonathan L||Device and Method for Monitoring of Absolute Oxygen Saturation and Total Hemoglobin Concentration|
|US20100317938 *||Jun 10, 2010||Dec 16, 2010||Kuhn Jonathan L||Device and Method for Monitoring of Absolute Oxygen Saturation and Tissue Hemoglobin Concentration|
|US20100317939 *||Jun 10, 2010||Dec 16, 2010||Kuhn Jonathan L||Device and Method for Monitoring of Absolute Oxygen Saturation and Tissue Hemoglobin Concentration|
|US20100317940 *||Jun 10, 2010||Dec 16, 2010||Kuhn Jonathan L||Absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction|
|US20100317943 *||Jun 10, 2010||Dec 16, 2010||Kuhn Jonathan L||Active Noise Cancellation in an Optical Sensor Signal|
|US20100317946 *||Jun 10, 2010||Dec 16, 2010||Kuhn Jonathan L||Shock Reduction Using Absolute Calibrated Tissue Oxygen Saturation and Total Hemoglobin Volume Fraction|
|US20100317947 *||Jun 10, 2010||Dec 16, 2010||Can Cinbis||Tissue Oxygenation Monitoring in Heart Failure|
|US20100318146 *||Jun 10, 2010||Dec 16, 2010||Can Cinbis||Tissue Oxygenation Monitoring in Heart Failure|
|US20100318149 *||Jun 10, 2010||Dec 16, 2010||Kuhn Jonathan L||Shock Reduction Using Absolute Calibrated Tissue Oxygen Saturation and Total Hemoglobin Volume Fraction|
|US20110066017 *||Oct 30, 2009||Mar 17, 2011||Medtronic, Inc.||Method and apparatus for post-shock evaluation using tissue oxygenation measurements|
|US20110066018 *||Oct 30, 2009||Mar 17, 2011||Kuhn Jonathan L||Method and apparatus for post-shock evaluation using tissue oxygenation measurements|
|US20110066198 *||Jul 29, 2010||Mar 17, 2011||Kuhn Jonathan L||Method and apparatus for post-shock evaluation using tissue oxygenation measurements|
|US20110066204 *||Jul 29, 2010||Mar 17, 2011||Kuhn Jonathan L||Method and apparatus for post-shock evaluation using tissue oxygenation measurements|
|US20110066206 *||Jul 29, 2010||Mar 17, 2011||Kuhn Jonathan L||Method and apparatus for post-shock evaluation using tissue oxygenation measurements|
|US20110106201 *||Oct 30, 2009||May 5, 2011||Sourav Bhunia||Implantable heart failure monitor|
|US20110172737 *||Jan 6, 2011||Jul 14, 2011||Medtronic, Inc.||Programming therapy delivered by implantable medical device|
|US20110172744 *||Jan 7, 2011||Jul 14, 2011||Medtronic, Inc.||Presentation of information associated with medical device therapy|
|US20110196451 *||Apr 14, 2011||Aug 11, 2011||Medtronic, Inc.||Communications Network for Distributed Sensing and Therapy in Biomedical Applications|
|US20110201948 *||Apr 25, 2011||Aug 18, 2011||Vital Sensors Holding Company, Inc.||Implantable pressure monitor|
|US20110201949 *||Apr 25, 2011||Aug 18, 2011||Vital Sensors Holding Company, Inc.||Anchored implantable pressure monitor|
|WO2006039525A2||Sep 30, 2005||Apr 13, 2006||Medtronic, Inc.||In-home remote monitor with smart repeater, memory and emergency event management|
|WO2006047403A1||Oct 25, 2005||May 4, 2006||Medtronic, Inc.||Method and apparatus for providing safe long-range telemetry with implantable medical devices|
|WO2006078936A1||Jan 18, 2006||Jul 27, 2006||Medtronic, Inc.||Method of graphical display of link status and fail-safe mechanism for safety during real-time medical device therapy|
|WO2006099035A1||Mar 9, 2006||Sep 21, 2006||Medtronic, Inc.||A communications system for an implantable device and a drug dispenser|
|WO2007027570A1||Aug 25, 2006||Mar 8, 2007||Medtronic, Inc.||Automatic parameter status on an implantable medical device system|
|WO2008002783A2||Jun 18, 2007||Jan 3, 2008||Medtronic, Inc||Local communications network for distributed sensing and therapy in biomedical applications|
|WO2008151231A1||Jun 4, 2008||Dec 11, 2008||Medtronic, Inc.||Method and apparatus for detecting noise in an implantable medical device|
|WO2010144652A1||Jun 10, 2010||Dec 16, 2010||Medtronic, Inc.||Tissue oxygenation monitoring in heart failure|
|WO2010144667A1||Jun 10, 2010||Dec 16, 2010||Medtronic, Inc.||Tissue oxygenation monitoring in heart failure|
|WO2010144668A1||Jun 10, 2010||Dec 16, 2010||Medtronic, Inc.||Tissue oxygenation monitoring in heart failure|
|WO2011053481A1||Oct 19, 2010||May 5, 2011||Medtronic, Inc.||Implantable heart failure monitor based on tissue oxygenation measurements|
|WO2013033296A1||Aug 30, 2012||Mar 7, 2013||Medtronic, Inc.||Method and apparatus for monitoring cardiac and respiratory conditions using acoustic sounds|
|WO2013062653A1||Aug 7, 2012||May 2, 2013||Medtronic, Inc.||Method and apparatus for calibrating an absolute oxygen saturation sensor|
|WO2013078010A1||Nov 8, 2012||May 30, 2013||Medtronic, Inc.||Method and apparatus for adaptive cardiac resynchronization therapy employing a multipolar left ventricular lead|
|WO2013078011A1||Nov 8, 2012||May 30, 2013||Medtronic, Inc.||Method for efficient delivery of dual site pacing|
|WO2013082126A1||Nov 28, 2012||Jun 6, 2013||Medtronic, Inc.||Use of thoracic and extra-thoracic impedance for diagnostic monitoring|
|WO2013152166A2||Apr 4, 2013||Oct 10, 2013||Medtronic, Inc.||Heart-sounds based adaptive cardiac resynchronization therapy timing parameter optimization system|
|WO2013162782A1||Mar 19, 2013||Oct 31, 2013||Medtronic, Inc.||Heart sound -based pacing vector selection system|
|WO2014004367A1||Jun 24, 2013||Jan 3, 2014||Medtronic, Inc.||Determining tachyarrhythmia detection parameters based on prior detected episodes|
|WO2015013258A1||Jul 22, 2014||Jan 29, 2015||Medtronic, Inc.||Identification of healthy versus unhealthy substrate for pacing from a multipolar lead|
|WO2015013271A1||Jul 22, 2014||Jan 29, 2015||Medtronic, Inc.||Identification of healthy versus unhealthy substrate for pacing from a multipolar lead|
|WO2016028615A1||Aug 14, 2015||Feb 25, 2016||Medtronic, Inc.||Visual representation of a cardiac signal sensing test|
|WO2016064661A1||Oct 16, 2015||Apr 28, 2016||Medtronic, Inc.||Sensing and atrial-synchronized ventricular pacing in an intracardiac pacemaker|
|WO2016064662A1||Oct 16, 2015||Apr 28, 2016||Medtronic, Inc.||Sensing and atrial-synchronized ventricular pacing in an intracardiac pacemaker|
|WO2016118374A1||Jan 13, 2016||Jul 28, 2016||Medtronic, Inc.||Multi-device implantable medical device system|
|WO2016172566A1||Apr 22, 2016||Oct 27, 2016||Medtronic, Inc.||Efficient delivery of multi-site pacing|
|WO2017027770A1||Aug 12, 2016||Feb 16, 2017||Medtronic, Inc.||Epicardial defibrillation lead with side helix fixation and placement thereof|
|WO2017119967A1||Dec 1, 2016||Jul 13, 2017||Medtronic, Inc.||Medical electrical lead|
|WO2017172271A1||Mar 6, 2017||Oct 5, 2017||Medtronic, Inc.||Atrial arrhythmia episode detection in a cardiac medical device|
|WO2017172272A1||Mar 6, 2017||Oct 5, 2017||Medtronic, Inc.||Medical system for detecting an atrial tachyarrhythmia through classification based on heart rate variability|
|U.S. Classification||600/483, 600/501, 600/522, 600/300|
|International Classification||G06Q50/00, A61B5/0205, A61B5/00, A61B5/0215, A61N1/372|
|Cooperative Classification||A61B5/02158, A61B5/0031, A61B5/02055|
|European Classification||A61B5/00B9, A61B5/0205B, A61B5/0215H|
|May 24, 2001||AS||Assignment|
Owner name: MEDTRONIC, INC., MINNESOTA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:WEBB, JAMES D.;BENNETT, TOM DEAN;REEL/FRAME:011835/0691;SIGNING DATES FROM 20010515 TO 20010522
|Dec 18, 2006||FPAY||Fee payment|
Year of fee payment: 4
|Dec 28, 2010||FPAY||Fee payment|
Year of fee payment: 8
|Jan 29, 2015||FPAY||Fee payment|
Year of fee payment: 12